The Book of Woe: The DSM and the Unmaking of Psychiatry (43 page)

4.
“I just wanted them to learn”:
Allen
Frances e-mail, January 6, 2012.

5.
“One of the reasons”:
Robins and Guze, “Establishment of Diagnostic Validity in Psychiatric Illness,” 983.

6.
They concluded that
T. pallidum
: For a comprehensive history of the discovery of syphilis and its significance to modern medicine, see Quétel,
History of Syphilis
. See also Greenberg,
Manufacturing Depression
, 52–60.

7.
a five-step process toward validity:
Robins and Guze, “Establishment of Diagnostic Validity,” 983–84.

8.
“validity tests . . . have not lived up”:
“Time for a Change?”
Psychiatric News
, August 21, 2009.

9.
Kenneth Kendler added another validator:
Kendler, “The Nosologic Validity of Paranoia.”

10.
“the [diagnostic] categories”:
Kendler, “An Historical Framework for Psychiatric Nosology,” 1939.

11.
“to consider our major diagnostic categories”:
Ibid.

12.
“critics of psychiatric diagnoses”:
Ibid.

13.
“A historic and scientific process”:
Ibid.

14.
“It sounded about right”:
Kendler et al., “The Development of the Feighner Criteria,” 136.

15.
“wonderful property of iteration”:
Kendler, “An Historical Framework,” 1940.

16.
“assure ourselves”:
Ibid.

17.
“
wobbly
iterations”:
Ibid. Emphasis in original.

18.
“asymptotes to a stable and accurate”:
Ibid., 1939.

19.
paleontologist Stephen Jay Gould:
See Gould,
Wonderful Life
.

20.
“We follow the tape forward”:
Kendler, “An Historical Framework,” 1938.

21.
“The ‘disastrous result’”:
“APA Disputes Critics of DSM-V,”
Psychiatric News
, August 21, 2009.

22.
“attempt to address”
 . . . “The single most important precondition”:
Regier et al., “Conceptual Development of DSM-V,” 649.

23.
“establish better syndrome boundaries”:
Darrel Regier e-mail, October 5, 2010.

24.
Some diagnoses, such as depression:
DSM-IV-TR, 413.

25.
Global Assessment of Functioning:
DSM-IV-TR, 32–34.

26.
National Institutes of Health had created PROMIS:
See www.nihpromis.org.

27.
“bottoms-up
approach”:
Regier et al., “Conceptual Development,” 648.

28.
“If they really want to do dimensional assessment”:
Michael First interview, September 28, 2010.

29.
“We don’t expect the DSM-5”:
Darrel Regier e-mail, October 11, 2010.

30.
Diagnostic criteria “are intended”:
Regier et al., “Conceptual Development,” 648–49.

Chapter 9

1.
“Advice to DSM V”:
Allen Frances, “Advice to DSM V . . . Change Deadlines and Text, Keep Criteria Stable,”
Psychiatric Times
(blog), August 26, 2009, www.psychiatrictimes.com/display/article/10168/1444663.

2.
in the field trials the new criteria identified 15 percent more:
Lahey et al., “DSM-IV Field Trials for ADHD,” 1682.

3.
the actual increase was 28 percent:
Akinbami et al., “Attention Deficit Hyperactivity Disorder Among Children,” 2.

4.
“everything was on the table”:
Allen Frances, “Alert to the Research Community,”
Psychiatric Times
, January 7, 2010.

5.
“over the cliff”:
Frances, “Advice to DSM-V.”

6.
“I take more blame for DSM-IV”:
Allen Frances interview, August 16, 2010.

7.
“some of us have gotten
”
:
Shirley Wang, “Psychiatrists Bash Back at Critics of Diagnostic Manual Revision,”
Wall Street Journal Health Blog
, January 8, 2009, blogs.wsj.com/health/2009//01/08/psychiatrists-bash-back-at-critics-of-diagnostic-manual-revision.

8.
“The development process has been so public”:
Alan Schatzberg, “Some Thoughts on DSM-V,”
Psychiatric News
, August 21, 2009.

9.
“I’m too small a fish”:
Jane Costello e-mail, August 1, 2010.

10. “
I cannot in good conscience”:
Jane Costello resignation letter, available at http://www.scribd.com/doc/17162466/Jane-Costello-Resignation-Letter-from-DSMV-Task-Force-to-Danny-Pine-March-27-2009.

11.
the response came from Darrel Regier:
Regier supplied me with the letter via e-mail, November 11, 2010.

12.
“Since we considered”:
Darrel Regier e-mail, November 11, 2010.

13.
“When there is smoke”:
Carolyn Robinowitz interview, October 4, 2010.

14.
the APA issued a press release:
American Psychiatric Association, “DSM-5 Publication Date Moved to May 2013,” news release, December 10, 2009, http://www.dsm5.org/Newsroom/Documents/09-65%20DSM%20Timeline.pdf.

15.
“long vetting process”:
Beth Casteel e-mail, November 11, 2010.

16.
“I’m going to be quite critical”:
Allen Frances, “DSM-V in Severe Distress: Is a Happy Ending Possible?” January 15, 2010, http://columbiapsychiatry.org/videos/dsm-v-severe-distress-happy-ending-still-possible.

17.
The APA posted a full draft:
Although it has since been taken down, the draft is available at http://web.archive.org/web/20100402094501/http://www.dsm5.org/ProposedRevisions/Pages/Default.aspx.

18.
“Anything you put in that book”:
Benedict Carey, “Revising Book on Disorders of the Mind,”
The New York Times
, February 10, 2010.

19.
“The 19 Worst Suggestions for DSM5”:
Allen Frances, “Opening Pandora’s Box: The 19 Worst Suggestions for DSM5,”
Psychiatric Times
, February 11, 2010, www.psychiatrictimes.com/print/article/10168/1522341?printable=true.

Chapter 10

1.
another letter to the trustees:
Frances, “To the Membership of the APA,”
Psychiatric Times
, June 2, 2010, http://www.psychiatrictimes.com/dsm-5/content/article/10168/1565491.

2.
“I was of age in the ’60s”:
Allen Frances e-mail, January 23, 2012.

3.
“I never yell”:
Ibid.

4.
“nice irony”:
Ibid.

5.
“This was the stupidest idea in the world”:
Allen Frances telephone interview, November 23, 2011.

6.
“After the third or fourth”:
Herb Peyser interview, January 23, 2012.

7.
Freud once said:
See Freud,
The Joke and Its Relation to the Unconscious
.

8.
“orderly and democratic process”:
David Shaffer interview, December 8, 2011.

9.
“David probably misinterpreted”:
Allen Frances e-mail, January 23, 2012.

10.
“that children with the broad phenotype”:
Leibenluft et al., “Defining Clinical Phenotypes of Juvenile Mania,” 436.

11.
“claim to define a new diagnosis”:
Leibenluft, “Severe Mood Dysregulation,” 131.

12.
“Justification for Temper Dysregulation Disorder with Dysphoria”:
“Justification for Temper Dysregulation Disorder,” http://www.dsm5.org/Proposed%20Revision%20Attachments/Justification%20for%20Temper%20Dysregulation%20Disorder%20with%20Dysphoria.pdf.

13.
it announced a new “naming convention”:
American Psychiatric Association, “APA Modifies DSM Naming Convention to Reflect Publication Changes,” news release, March 9, 2010.

14.
“distinctly unmedical”:
Schatzberg, “Presidential Address,” 1163.

15.
“Some of the attacks”:
Ibid.

16.
New Orleans had “risen as the Phoenix”:
Ibid., 1162.

17.
“the negative attacks on industry”:
Ibid., 1164.

18.
“There are a number of new drugs”:
Ibid.

Chapter 11

1.
“Turning bereavement into major depression”:
Allen Frances, “Good Grief,”
The New York Times
, August 14, 2010.

2.
“Sure, there’s a reality out there”:
Allen Frances interview, August 16, 2010.

3.
“The full truth”:
Allen Frances e-mail, February 2, 2012.

4.
“Like most medical specialties”:
Allen Frances interview, July 7, 2011.

5.
“stigmatization [and] inappropriate care”:
Wakefield et al., “Extending the Bereavement Exclusion,” 433.

6.
“ignore the many other kinds”:
Ibid., 434.

7.
“define every undesirable consequence”:
Horwitz and Wakefield,
The Loss of Sadness
, 220–21.

8.
“Psychiatry has made immense strides”:
Ibid., 225.

9.
“There are few signs”:
Ibid., 212.

10.
“It just doesn’t make any sense to me whatsoever”:
Sidney Zisook interview, September 10, 2010.

11.
Zisook did some data mining of his own:
Zisook and Kendler, “Is Bereavement-Related Depression Different Than Non-Bereavement-Related Depression?”

12.
“provides some support”:
Ibid., 791.

13.
“Because work toward the DSM-V”:
Zisook et al., “Validity of the Bereavement Exclusion,” 102.

14.
“validity of the bereavement exclusion”:
Ibid., 104.

15.
“Why should bereavement be singled out”:
Ibid., 105.

16.
“Idiotic”:
Jerome Wakefield e-mail, January 31, 2012.

17.
a study showing that GSK’s Wellbutrin:
Zisook et al., “Buproprion Sustained Relief for Bereavement.”

18.
“The DSM-IV position is not logically defensible”:
Kendler, “Grief Exclusion,” http://www.dsm5.org/about/Documents/grief%20exclusion_Kendler.pdf.

19.
“that sadness in response to loss”:
Wakefield et al., “Extending the Bereavement Exclusion,” 439.

Chapter 12

1.
“the best we can do”:
See Allen Frances, “The Most Important Psychiatrist of Our Time,”
Psychiatric Times
, December 22, 2010.

2.
“Moving forward”:
Regier, “Diagnostic Threshold Considerations for DSM-5,” 293.

3.
“the clinical judgment of a psychiatrist”:
Ibid., 285.

4.
the National Comorbidity Survey:
Kessler et al., “Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States.”

5.
“We had much greater confidence”:
Ibid., 286.

6.
Regier’s team began to dig them out:
Narrow et al., “Revised Prevalence Estimates of Mental Disorders in the United States.”

7.
“To put it mildly”:
Regier, “Diagnostic Threshold Considerations,” 288.

8.
Wakefield and Spitzer pointed out:
Wakefield and Spitzer, “Lowered Estimates—but of What?”

9.
“What is striking about this debate”:
Regier, “Diagnostic Threshold Considerations,” 289.

10.
“to define the problem out of existence”:
Kessler et al., “Mild Disorders Should Not Be Eliminated from the DSM-V,” 1.121.

11.
“In response to this scientific critique”:
Regier, “Diagnostic Threshold Considerations,” 289.

12.
“I wasn’t aware that he had interpreted”:
Ronald Kessler e-mail, February 9, 2012.

13.
“Certainly some of the loudest concerns”:
Regier, “Diagnostic Threshold Considerations,” 290.

14.
Just look at the history of “progress”:
Ibid.

15.
“It may be of interest”:
Ibid., 292–93.

16.
“Since the broad definition”:
Ibid., 293.

17.
“DSM-IV has a label for everyone you might want to treat”:
Roger Peele interview, November 4, 2011.

18.
his $600,000-per-year salary:
That is as of 2010, according to the APA’s tax return, available at http://www.guidestar.org/FinDocuments/2010/130/433/2010-130433740-077883c7-9.pdf.

19.
“The spirit of moderation”:
Montesquieu,
The Spirit of Laws
, 49.

20.
“They [the dimensional measures] will continue to evolve”:
Darrel Regier e-mail, September 29, 2010.

Chapter 13

1.
more than eight thousand comments:
Joan Arehart-Treichel, “DSM-5 Work Groups Assess Thousands of Comments,”
Psychiatric News
, August 20, 2010.

2.
“developed a strong sense of uniqueness and belonging”:
Bernstein, “DSM-5: Year Ahead and Year in Review,”
Psychiatric News
, August 20, 2010.

3.
“I fought to get myself comfortable in high school”:
Nomi Kaim interview, June 16, 2011.

4.
“It was a total add-on”:
Fred Volkmar interview, March 1, 2012.

5.
The disorder was first described by an Austrian pediatrician:
See Wing, “Asperger’s Syndrome: A Clinical Account,” and Lyons and Fitzgerald, “Asperger and Kanner, the Two Pioneers.”

6.
“an especially intimate relationship”:
Wing, “Asperger’s Syndrome,” 117–18.

7.
“pervasive lack of responsiveness”:
DSM-III, 89.